PNHP

Complex eligibility variables create inequities

'Broad' health care tax cut for small business leaves out some companies

By Ricardo Alonso-Zaldivar
Los Angeles Times
May 19, 2010

When the administration unveiled the small business tax credit earlier this week, officials touted its “broad eligibility” for companies with fewer than 25 workers and average annual wages under $50,000 that provide health coverage.

Lost in the fine print: The credit drops off sharply once a company gets above 10 workers and $25,000 average annual wages.

It’s an example of how the early provisions of the health care law can create winners and losers among groups lawmakers intended to help ā€” people with health problems, families with young adult children and small businesses. Because of the law’s complexity, not everyone in a broadly similar situation will benefit.

http://www.latimes.com/business/nationworld/wire/sns-ap-us-health-care-tax-cut-fact-check,0,3521831.story

Comment: 

By Don McCanne, MD

We could have had a health care financing system that automatically included everyone. Instead we enacted a complex, fragmented system with so many eligibility and payment variables for a large variety of plans and programs that it is impossible to fit everyone into a slot. Not only is this the most expensive way to pay for health care, it also ends up being inequitable since individuals with similar circumstances can end up having quite different financial obligations, or even end up with one covered and the other not.

It doesn’t have to be this way. We can still enact a single payer national health program that would cost less and actually work for everyone.

Complex eligibility variables create inequities

‘Broad’ health care tax cut for small business leaves out some companies

By Ricardo Alonso-Zaldivar
Los Angeles Times
May 19, 2010
When the administration unveiled the small business tax credit earlier this week, officials touted its “broad eligibility” for companies with fewer than 25 workers and average annual wages under $50,000 that provide health coverage.
Lost in the fine print: The credit drops off sharply once a company gets above 10 workers and $25,000 average annual wages.
It’s an example of how the early provisions of the health care law can create winners and losers among groups lawmakers intended to help ā€” people with health problems, families with young adult children and small businesses. Because of the law’s complexity, not everyone in a broadly similar situation will benefit.
http://www.latimes.com/business/nationworld/wire/sns-ap-us-health-care-tax-cut-fact-check,0,3521831.story

We could have had a health care financing system that automatically included everyone. Instead we enacted a complex, fragmented system with so many eligibility and payment variables for a large variety of plans and programs that it is impossible to fit everyone into a slot. Not only is this the most expensive way to pay for health care, it also ends up being inequitable since individuals with similar circumstances can end up having quite different financial obligations, or even end up with one covered and the other not.
It doesn’t have to be this way. We can still enact a single payer national health program that would cost less and actually work for everyone.